Blog 12 4/22/24
Age-Related Changes in the Body
A participant told the group that they were baffled by symptoms and could not find trauma or other reasons for an onset of depression or anxiety and that it didn’t make any sense. When their age is considered, the factors of hormonal changes in the body must be considered. (Kheirkhah, Hosseini, Hosseini, Ghasemi, Bijani & Cumming, 2014); (Lisanby, 2020).
There are physical changes in our bodies as we age. The body can develop diseases, allergies, heart conditions, eyesight problems, arthritis, or other diseases. Hormonal changes are a problem for men and women. Hormonal changes in people around age 40-50 years of age that will cause problems with depression anxiety, and psychosis (Lisanby, 2020).
The participant was surprised about age-related changes in the body and realized that this was a long discussion with their doctor. Acceptance of what we have and who we are is part of the Mindfulness Response.
What is serious mental illness?
“Serious mental illness” is a term that refers to mental disorders that usually affect people in early adulthood and often have profound effects on family relations, educational, occupational productivity, and social role functioning. Disorders include schizophrenia, schizoaffective disorder, bipolar disorder, major depression, autism, and obsessive-compulsive disorder. These disorders affect at least 2.8% of the population or 5 million people (NIH 2022).
Serious Mental Illness (SMI) is defined as a mental, behavioral, or emotional disorder resulting in serious functional impairment. SMI is a term identifying the disorders that interfere with or limit one or more major life activities (NIH 2023).
Participants realized that they couldn’t avoid anxiety, depression, grief loss problems, or psychosis. They chose to stay sober and not drown their intense feelings in alcohol or drugs. They used a team approach to help heal themselves and maintain stability.
The Brain is an Organ
The brain is an organ, and it sends messages all over our body. The brain is no different than the heart or the kidneys. Like other organs, it needs healthy foods, rest, relaxation, and inspiration. People are prescribed medications or surgery when there is damage to the heart. When there are problems with the brain, participants said they were told to “buck up, just get over it,” or “deal with it.”
The brain is the most complex organ in the body and is still under research. Participants talked about theories that emphasize positive thoughts and imagining good things coming to you. Participants reported that this was difficult to do because the psychosis has extra layers of symptoms that interfere with concentration. They talked about reaching a satisfactory level of contentment in their life, but their life wasn’t always about happiness. The group discussed acknowledgment and learning from different emotions and accepting them. Participants chose to learn from happiness, sadness, grief, loss, anger, embarrassment, and trauma issues and became wiser for doing it.
Why do people develop psychosis?
Four identified groups of people develop psychosis that researchers identified. Some groups are affected by genes, neurodevelopment, and growth. Environmental factors, such as poverty, trauma, racial discrimination, health care access, or poor supportive care influence other groups. Stigma and the ability to seek out help is another factor. There are four different reasons why people develop psychosis, as elaborated by Stevens, Spencer & Turkington (2017).
Four Subgroups of Trauma: Reasons Why People Develop Psychosis
1. Trauma in Childhood
The first group is those who experience trauma in childhood. Traumatic events that occur in childhood affect the way that the child’s brain grows and perceives things in the environment. The first group experienced multiple traumas in the early years of development. The brain is affected by bullying, neglect, witnessing violence, or becoming a victim of violence. Participants discussed misperceptions and negative internalized beliefs. The group emphasized that they did the best they could since the abuse occurred in childhood. the group discussed how a child lacks the skills that an adult would have. The group also discussed beliefs that can become delusional and old habits that were formed. Participants acknowledged actions that were done to create safe environments.
Trauma creates strong emotions of depression, shame, guilt, and anxiety. Participants talked about problem behaviors that they wanted to reduce, such as outbursts of anger, loss of concentration, irritability, self-injurious behaviors, suicidal ideation, thoughts, and suicidal plans, running away, dissociation, pseudo-seizures, and hallucinations associated with trauma.
Participants were introduced to negative thoughts and messages that can start in childhood and continue into adulthood. Perceptions are affected in early childhood and continue to color our lives as we age. It’s estimated that 1/3 of those with mental health issues in adulthood could have been prevented with more social and community support during early childhood. Participants talked about intrusive delusional beliefs and tried to ignore them. Some talked about how they were formed by responses to trauma. Group therapy discussions included hallucinations, pseudo-seizures, dissociation, self-injurious behaviors, anxiety, shame, depression, and guilt that can result from trauma in early childhood.
Treatment for this includes Cognitive Behavior Therapy (CBT) education, and restructuring thoughts, feelings, and coping skills. Managing and identifying emotions helps reduce shame, guilt, and anxiety (Stevens, Spencer & Turkington 2017).
Trauma in Childhood Creates Psychosis
Traumatic Experience: Violence, victim of violence, neglect, bullying, assaults, robbery, discrimination
Abuse: Verbal, emotional, physical, sexual, harassment, being stalked
PTSD symptoms: Nightmares, flashbacks of trauma memories, hyper-vigilance, fearfulness,
Irritability, loss of concentration, avoidance, checking over my shoulder, making sure I am safe all the time, checking that doors and windows are locked
De-personalization: The feeling that you are observing yourself, dissociated, or being outside of your body
De-realization: Feeling as if things around you are not real
Psychosis: Delusional beliefs, hallucinations, paranoia, disorganized thinking, disorganized behaviors
Hallucinations: Visual, auditory (voices or sounds), smells, taste, touch, internal sensations, feeling as if there is no boundary between my body and others, feeling like the walls are moving, feeling like I am not grounded or present, feeling like I am just a shell
Dissociation: Loss of time and place, not feeling connected to your inner-self, your body
Behaviors: Self-injurious behaviors, self-harm, running away, pseudo-seizures, somatic
Constant physical ailments, pains, isolation, withdrawal from others, poor communication, poor social skills, loss of jobs,
Emotions: Shame, guilt, self-blame, mood swings, panic attacks, anxiety, being overwhelmed, hiding one’s feelings
Grief and loss: Loss of dreams: Drop out of school or college due to cognitive decline
Treatments
Therapy: Cognitive Behavior Therapy: Identify emotions, negative thoughts, and actions. Dialectical Behavior Therapy: Emotion Regulation, Distress Tolerance, Mindfulness, Interpersonal Effectiveness
Family therapy
Individual Therapy
Psychiatry, medications
Community: social workers, occupational therapy, vocational rehabilitation
Alcoholics Anonymous, Narcotics Anonymous, Al-Anon, and others
Chemical Dependency Treatment
EMDR: Eye Motion Desensitization and Reprocessing
Legal issues: Court orders for treatment and medications, arrests, probation, parole
2. Inherited Diseases and Disorders
Neurodevelopmental diseases and disorders can bring about psychosis symptoms. We all have a genetic vulnerability that we inherit from our parents. The group discussed genetic vulnerability and how they noticed it on the mom’s side or the dad’s side of the family. The group discussed how mental illness is kept secret. There were numerous conversations about genes that produce Schizophrenia, Schizoaffective Disorder, Major Depression, or Bipolar Disorder with Psychosis. Hormonal changes associated with pregnancy or perimenopause can bring on mood changes and some cases include psychosis. Some diseases have psychosis as a symptom, such as Parkinson’s Disease or Dementia, and Huntington’s Disease.
Participants talked about inherited diseases and when they noticed symptoms getting worse, where they were socially isolated, poor at communicating, or clumsy. The group talked about hiding emotions to avoid becoming a victim. The group discussed becoming homeless, developing PTSD, or being at risk for substance abuse.
Participants who have inherited diseases need support from family and friends to rebuild their lives and develop new goals. Cognitive decline, or loss of intellectual learning comes over years with these diseases. Learning different skills, developing hobbies, and creating new interests help to direct and motivate a person to find a purpose and meaning in life.
One participant who was highly proficient in science, math, and in graduate school developed psychosis. The group talked about low motivation, poor self-care, and graduate school became a distant goal. The family intervened to start treatment and find what could help. The participant had many skills, but depression increased as dreams of higher education evaporated. The participant and the family reconsidered life goals and decided that treatment was most important, and higher education came second.
The family brought attention to the severity of the disease and that they valued the participant over a graduate school education. They discussed the grief and loss of dreams in life that would not be accomplished this year and maybe not the next. The process of applying self-compassion enabled the participant to focus on the present moment and what could be done today. Caring for oneself today will help with tomorrow. The participant realized the value of the family, their support and love, and that they wanted the participant to be a part of their lives (Stevens, Spencer & Turkington 2017).
3. Trauma in Adulthood Creates PTSD and Psychosis
This type of psychosis is triggered by a traumatic event, and the symptoms may be a response to the initial trauma. A voice may resemble a flashback. This creates more nightmares and flashbacks, which in turn creates insomnia, poor sleep, poor concentration, and increased arousal.
These symptoms are followed by psychosis, which is linked to the initial trauma. Hyper-vigilance is the result of being exposed to trauma and threatening situations for a long period. A veteran exposed to combat over months and years may be vulnerable to this type of psychosis. Some who have been held as prisoners of war, or those who have been in prison for long periods may develop this type of psychosis.
A participant was incarcerated for years and then released. The participant had a suicide attempt, was admitted to inpatient mental health, had medication changes, and then referred to the program. The participant learned to shut down and not express emotion as a survival skill during prison time. The participant looked tired and inner-focused. The group was patient with this participant and waited for natural curiosity to grow.
The group observed the participant and was aware of small changes, and non-verbal communications. Initially, the participant was quiet and reluctant to talk. Eventually, the participant was listening and watching others interact in the group. The participant tried to remain quiet, but curiosity grew about other’s conversations. The participant was surprised by others, many of whom had experienced mental health problems, mood disorders, psychosis, multiple hospital admissions, and had been in the program in the past, and how they talked openly in group therapy.
Through repetitive work in self-compassion, the participant learned to understand himself, how he survived, and how it affected him. He acknowledged trauma but didn’t want to talk about it and was told to bring details to individual therapy. He began his healing process when he allowed himself to feel what was bottled up from the past. He asked other group members about their experiences with trauma and psychosis and got a lifeline back to his humanity (Stevens, Spencer & Turkington 2017).
4. Psychosis Induces PTSD
Psychosis can bring about PTSD when a person is re-traumatized from acute psychosis. When a participant has symptoms of psychosis and it worsens, it becomes complicated. Thoughts can become disorganized or delusional. Participants experiencing these symptoms are in another reality, and when others interrupt it, the result can be frightening. They are triggered by the uncertainty of the situation. This can bring about a sense of hopelessness and helplessness. They need help to relieve their level of distress. They need understanding from others to be able to do a reality check on their belief system and how their symptoms are creating more distress. They may need more professional help if the belief is based on paranoia or strong feelings.
One participant was raised by both parents, lived in a quiet neighborhood, and had taken anti-psychotic medications for ten years. The participant reported being stable, maintaining a part-time job, and keeping his apartment. The participant noticed that the medication changes were not working as well. After many weeks of this new regimen, the participant contacted the clinic to tell them. The participant noticed that an anxious and depressed mood persisted, rather than stop with medications.
Unable to manage the increased anxiety and fearfulness, the person went to the Emergency Department with their parents and was admitted to an inpatient mental health unit. The participant recalled a nightmare about their body doing one thing and the mind revolting and doing another.
A participant told the ED doctor that they didn’t trust their mind and were afraid of it. The participant said that anxiety pushed fears into paranoia, and the person got agitated believing that the staff could not be trusted. With medication adjustments, the participant realized how staff helped him and that his mind was in a state of paranoia. The participant discussed how triggers of fear and dread were difficult to manage and they didn’t trust their judgment. The participant noticed a flashback and talked to the group about how scared and afraid they felt. The person talked about how the incident became a PTSD trigger.
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